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Pandemic preparedness & management – Roundtable Report

01 October 2009     London
Hosted by theHRDIRECTOR.
Chaired by Jason Spiller.

DELEGATES
Kate Bellamy, Senior Technical Advisor – Institution of Occupational Safety and Health (IOSH)
Nigel Brown, Director of Employee Relations & Head of Health & Safety – AXA UK
Michael Calvert, General Manager – Aastra Telecom (UK) Ltd
Dr Nigel Dowdall, Head of Wellbeing – British Airways
Melanie Flogdell, Head of HR Policy – Centrica Plc
Ann Healy, Group Business Continuity Manager – Centrica Plc
Gordon H. Irving, Group Security Director – ScottishPower
Christine Moore, Head of BT People Consulting – British Telecommunications Plc
Roger Newport, HR Business Partner – Volkswagen Group UK Ltd
Mark Roylance, Corporate Account Manager – Pandemic Centre of Excellence, GlaxoSmithKline
Mandy Rutter, Clinical Consultant Business Manager – AXA ICAS
Elaine Smart, HR Manager – British Heart Foundation

The purpose of the roundtable was not to compare one organisation’s preparedness over another. The focus was to gain a better understanding of how a pandemic might affect business, business organisations, the business community and society in general.

The impact of crisis such as; fuel shortages, strikes, power cuts, and terrorism is immediate on the normality of everyday life. It does not take a great deal of imagination to visualise the impact of a full scale pandemic. The objective of the roundtable debate was to promote the importance of awareness and to have plans in place, should pandemic occur. It was also to provide theHRDIRECTOR readers with informative, practical and strategic advice and to assist in the formulation of a cohesive strategy for coping with pandemic.

Are business organisations really taking the threat of pandemic seriously, and taking measures to prepare for this likelihood?

Mark Roylance: GSK takes pandemic preparedness very seriously. We have done internally for many years. It’s good to hear that so many companies are saying the same thing. Obviously our plans are based around H5N1 and with swine flu starting as it did, we’ve had to adapt our plans and move with the different pieces of information that have come out like everyone else. So far I certainly feel that we’ve got off lightly with H1N1 and obviously we’ve still got wave two to come and potentially wave three and I’ll see how they unfold and how the government responds to all of that as well. But I think for me, and you’ve already said it, the bigger picture is what would have happened if this had

been H5N1? What would have happened if this had been a 1918 scenario? How would the country have coped? Would they have got the telephone line up in time? How would different organisations have coped with that amount of fatalities and seriously ill people? So for me the bigger picture is be prepared, whatever form it comes in.

Kate, could you just give us an overview of what we’re actually dealing with, in regard to these pandemics, particularly the flu virus?

Kate Bellamy: Flu pandemics happen every 25 to 30 years. It occurs when viruses mutate and become more virulent, they cross species from animals to humans. The current thinking of this H1N1 is that it will actually infect 25 percent of the population. The pandemic will occur in waves. The waves could be as long as 12 to 15 weeks with a gap in between so we have to be prepared for numbers to increase, go down and then increase again.

And what is the prognosis? Is there any way of knowing how this will manifest itself?

Kate Bellamy: I think yes, the numbers will probably go up. And certain age groups will be more susceptible. The five to 24 year olds and those with underlying health problems will be most susceptible to this virus.

Roger, your business relies on a cohesion and networks. What was the impression you got from your employees?

Roger Newport: Naturally there is some concern because people read the papers and watch the television. We saw a rise in enquiries about people asking for the company’s view? For example, if somebody was feeling unwell, what should be done about it? We had some global guidance from our parent company which was mainly focused on travel, for example, putting restrictions on going to Mexico. But locally (i.e. nationally), we determined our own position. I took a pragmatic approach to it and just reassured. It was a question of maintaining a balance.

Nigel, I should imagine in terms of aviation, preparation is everything.

Nigel Dowdall: We were impacted straight away because we operate to Mexico which, of course, is where it first came up and, at that time, appeared to be a more serious illness with more deaths. The World Health Organisation have always been a key player for us in terms of providing the basic information and we try and follow that line, but we also try and influence that line if we think they’re going off message or they’re getting it slightly wrong, or not recognising particular issues. And for us in our planning, a key part of the liaison has been between IATA, which is our international trade body, and the World Health Organisation and ICAO, which is the international regulatory body. WHO fortunately stuck to the pre-planned party line and that certainly helped. But the initial response? Yes, there was a lot of anxiety.

In terms of essential utility providers, I imagine that you would have had plans already in place for such an event.

Gordon Irving: Similar to everybody, we’ve got office-based staff, you’ve got your people who are in the field and then you’ve got your staff who are engineering, the people who are in the power stations keeping the power going. And it’s all about trying to get your message across to everyone, which isn’t that simple at times. And it’s all about getting the message to the office-based staff and letting them see something visual as well. But also within the power station where there’s several hundred people working and the conditions are totally different to an office, it’s obviously getting the same type of message there, but maybe scaling it back slightly. We found the communication very relevant and it was all about a timing issue.

Mark Roylance: You’ve got be cautious about the “cry wolf” syndrome. First we had SARS, then bird flu and we thought well, nothing really happened; but there was a lot of noise. Therefore, this is going to be the same. But swine flu occurred with real speed. We first heard about it April the 16th and by April the 30th we were at phase five and I don’t think anybody expected to move through the phases that fast.

Planning and communication it seems, is critical with an unknown force such as pandemic.

Mel Flogdell: Definitely. I think that we were fortunate because we had been working on this for a long time and working with the Government, so we did have communications in place. I think we did need to revisit them because it was, as everyone has said, about achieving a balance: not panicking employees but reassuring them that we did have robust plans in place and also making them aware of what information is available; whether that’s directing them to external sites or referring them to the frequently asked questions we produced.

Gordon Irving: Because of our utility position we had to start to report our sickness to the Government in relation to a daily check to ensure that we were able to maintain the flow of electricity. And to change the in-house HR sickness reporting systems do take time. You just can’t do it overnight and it took us about three or four weeks to actually change our reporting systems.

Nigel Brown: AXA concluded that rather than use the old system and the way we normally reported sickness absence, we would use our AXA HR service and we would ask all the managers to phone in with details of who was off sick with swine flu.

Christine Moore: We had the same experience. We’ve got an automated reporting system for sickness absence and to change that would be a major undertaking. So we’ve added an additional report chain so that people report absences in the normal way, and also through a dedicated site so we’re able to keep accurate numbers.

And how do you manage that? How do you control that data and what do you do with that data?

Christine Moore: That’s controlled centrally, so all the data goes into a central point from where the statistics are produced. It covers the UK and now the Republic of Ireland as well.

On the basis that a chain is only as strong as its weakest link, some companies are doing best practice, there are companies that aren’t. Surely there needs to be a more centralised approach?

Gordon Irving: Government tries to pull together centrally though the Cabinet Office; one section will deal with electricity, one section will deal with gas, one section will deal with oil and one section will deal with water and sewage. They try and draw it together centrally through the Cabinet Office and try and ensure through that mechanism that everyone’s plans fit with each other, and there will be support. We are all working closely with the Government and there are still twice weekly meetings.

Mark Roylance: There is a business advisory network for flu, which they’ve been recruiting from different organisations. Gordon, I’m interested to know how does the Civil Contingency’s framework affect your company, being a category two responder. How many demands have the government placed on you? Has it been autocratic? Or has it let you get on with what you needed to do?

Gordon Irving: There’s been good dialogue; it hasn’t been autocratic at all. We have to work through what it would look like with a 20 percent, 30 percent, 40 percent up to 60 percent effect on workforce within certain functions. We’ve advised the Cabinet Office of our top ten major risks, including such issues as supply of coal coming in through the ports and transportation links.

That’s a domestic UK strategy, what about control and management internationally?

Michael Calvert: Business continuity is absolutely key and that, in many cases, for businesses to be able to successfully operate, they need a technological infrastructure. And many companies assume that simply providing some of their key workforce with a GSM and a laptop means that they’re able to operate. That’s simply not the case. If links in that communication chain break down, very rapidly business will grind to a halt.

Mark Roylance: It’s interesting how it affects different business in different ways. It’s the unintended consequences of pandemics that are quite interesting. Some companies, like GSK, probably the demand for our resources, our products would go up and others would be significantly impacted.

How do organisations look after farflung expat employees in such incidents?

Nigel Brown: We have a number of people who travel to India. Therefore, if we had people out there, as long as we were providing them with reasonable medical attention even if they got swine flu, they would be okay. If we’d had a different situation where, as it appeared initially from Mexico, that the death rates were very high then I guess we would have had to react in a different way and we would probably have been bringing people back and reducing travel.

Nigel Dowdall: During BA’s pandemic planning we talked to a lot of our corporate customers and the general sense was, with what was known or expected of a pandemic then, that their early reaction would be to pull back all their ex-pats and to stop travel. It was interesting, quite a lot of companies stopped travel to Mexico. When it went to the States, that idea seemed to disappear and I’m not aware of any organisation which stopped travel to the States.

Is that a perception that the States would be more organised and more able to cope with a pandemic?

Nigel Dowdall: Possibly, the fact that if you’re in the States and get unwell, it’s as good a place to be as any would certainly have an influence.

Is there something to be said for immediately setting a potential risk at red alert does this come across as crying wolf when the risk winds down rapidly afterwards?

Mark Roylance: The WHO scale is based on a certain set of criteria and that doesn’t include severity. It was following steps and this didn’t necessarily tie up with what governments/companies/people needed to know. It will be Interesting to see how the phasing develops.

Nigel Dowdall: WHO have said that they will carry out a formal review of their response once the pandemic has ended, as they did with SARS. They have already indicated that they will revise how they escalate the levels.

Nigel Brown: Regular factual, relatively calm communication is absolutely key. I think we found that the press coverage was a bit sensationalist in this country. We were communicating to employees a balanced picture, people that had seen coverage in the media, and we had to overcome some of that through calm, factual and regular communications. And that’s what we tried to do throughout.

Christine Moore: BT did a lot of planning in advance on our communications and a lot of the press publicity was somewhat alarmist, we found. Similarly, we were getting queries about whether buildings would be closed down, for example, if one person was found to be suffering from swine flu. And whilst you can direct people to Government information and WHO information, I think there’s no substitute for just common sense, clear advice from the employer and really repeating some very basic guidelines about hygiene, about how to prevent infection spreading.

Mandy Rutter: Pandemic Flu has some characteristics that are the greatest things for causing anxiety, i.e. unfamiliarity, unpredictability, chaos and fear of death. All these things cause people’s adrenalin to rise and when people are very anxious they stop thinking. They resort to a very emotional response first rather than a practical response.

Mel Flogdell: I was going to say on top of the communication, which is probably the biggest thing for companies, it’s, as Gordon said, really around robust absence monitoring and also around being able to identify your critical roles, your critical workers to make sure that you’ve got plans in place so that your organisation can run on a reduced workforce. Also that your suppliers have got plans in place and they’ve been tested as well.

Michael Calvert: I think that has been one of the big things about this. Because of the amount of profile it’s had, we’ve really seen that companies of all sizes have taken business continuity planning an awful lot more seriously. And that’s relevant for any type of unexpected event. Companies are thinking much more about their entire supply chain, their organisational structure and how they can best work through any of these types of unexpected events.

Mark Roylance: GSK does have good business continuity plans, but again it’s the thing you haven’t foreseen that normally trips you up.

Nigel Brown: I would say that a couple of years ago the Financial Services Authority organised for all the insurance companies to do some scenario planning on the basis of bird flu. And even though many of the things that were given in those scenarios weren’t what actually happened, the process of doing some of the activities and thinking about some of those issues beforehand meant that when we came to do this one, we felt a bit more confident about what we were doing.

But it is the weakest link issue. You cannot cater for one person not following good hygiene, going on a plane and infecting dozens of others. How can we communicate the importance of personal responsibility without turning people off?

Christine Moore: BT’s done a lot of communications on good hygiene and really how basic it is in terms of the need to wash your hands. And also what a thorough washing of the hands means; how long it should take and so on. We’ve also put up reminder notes in the toilets. I think you get to a point where you’ve done all you can.

Gordon Irving: We noticed a peer pressure thing started to kick in. And if you were in the toilets guys would actually look to make sure that you washed your hands. You’ll never be able to enforce it though.

Mark Roylance: It’s media dependent. I think maybe at the height of wave two we’ll be seeing people wiping their hands and hygiene will improve, through fear of infection Mandy Rutter: It’s both employee and employer responsibility. In any human aspect of any crisis situation, we all have a responsibility to do what is best to maintain our own wellbeing. Our approach is very much tending to treat people as adults.

Roger Newport: It’s a process of constant education. You introduce the gels, everyone notices them for two days then it’s as if they magically disappear and aren’t noticed; they become just part of the furniture. So I think you have to keep awareness up in a variety of different ways.

Should usage of gel, for example, be administered, as on some cruise liners and in certain hospitals?

Nigel Brown: We found that doing a desk cleaning regime was helpful, almost psychologically, because employees had to ring our Ask HR helpline to report and request the cleaning, so we were able to monitor the numbers and gave them an incentive to report it. Then it was arranged for somebody to go and clean the desk. People would see that was happening, reinforcing the hygiene message.

Nigel Dowdall: There’s quite a challenge there. It’s all very well having desk cleaning reviews but in an organisation like ours, the majority of our staff don’t work at desks. Let’s not get paranoid about trying to keep the place clean because it doesn’t work.

Gordon Irving: You don’t want to create different classes of workers and that’s the big danger because no matter how diverse a company you are, workers do talk to each other, and there’s a balanced approach to all this.

Mel Flogdell: I do think there is a point with regards to education outside of the workplace because I was in a Post Office and there was someone at the counter on their mobile phone speaking to somebody and they said to their friend, ‘Oh yes. I’ve been to the doctor’s. I’ve got swine flu. They’ve given me some Tamiflu thing but I haven’t taken it. No, I’m not staying at home, I’m just in the Post Office at the moment.’ I’ve never seen a queue go down so quickly!

So containment is futile? What do we tell employees that suspect they may have the virus?

Roger Newport: That’s a very tricky one. You get a variety of opinions in the workplace. You get some line managers that have quite a cynical view and think people are throwing sickies. I think there’s certainly been some cynicism around self certification on swine flu. Then you’ll get the other camp who say employees should stay at home and not come in and infect everybody. And, of course, you get people in those circumstances who feel like they’re letting their colleagues down by not coming in.

Martin Calvert: I think the media messages have been quite confused as well. I don’t think there’s been any one clear message about what you should do, even if you have a suspected case.

Mandy Rutter: There has been some good advice from British Occupational Health Foundation about how to help managers talk to people who are coming in to work with symptoms.

Mel Flogdell: I think there’s another element to it as well, in that for some people if they’re not going to be paid for having the time off, then they will want to come in to work. So our approach is very much you don’t come in to work if you’ve got symptoms or suspected symptoms. And it is about then what your attendance management policy, is with regards to payment of individuals.

Elaine Smart: But if they’re working from home wouldn’t that affect the stats that you collect? Because we have people that have said, ‘I’ve got suspected swine flu. I’m going to be working from home,’ so we don’t necessarily report them as sick on the database, because they’re working from home; they’re putting in a day’s work. So it skews the stats.

There is some real ambiguity here, what’s the solution?

Christine Moore: We’ve taken the position that we’ve educated people about the symptoms, how to recognise them. We think that we can rely on their common sense to act responsibly towards themselves and their colleagues. In terms of absence management we don’t automatically discount swine flu related absences from our attendance policy but we do accept that swine flu is an exceptional circumstance.

What if a pandemic takes hold and is severe, surely the status quo regarding sickness pay and recording and monitoring absenteeism, would all have to change.

Christine Moore: I think we’d have to review it if there was a significant deterioration in the situation.

Nigel Brown: One of the big saving graces with swine flu has been the fact that the period for which someone is sick is normally seven days, which ties in, with most companies, with self certification approaches. If the period of people being off had been 14 days, then we’d have had an immediate problem to address.

What about mainstream awareness campaigns on television and radio?

Nigel Brown: I suppose the thing that works more than anything else is if you’re in a team and you know that you’re contribution will have an impact on other people if you’re not there, that is a team with a good spirit. If you can create that then people will not take time off unless they’re genuinely ill because of that wish not to let down their friends and colleagues and put them in a difficult position will be very important.

Mandy Rutter: Business continuity is about organisational resilience, but actually what about individual resilience? How can you encourage people to maintain wellness and understand their own resilience. What does it mean to be well as opposed to what does it mean to be sick? Maintaining resilience is not just about receiving information from one source, it’s about receiving information from lots of different sources and weighing it all up.

Christine Moore: I think it depends to a degree on the culture of the organisation. If you have a business where it’s normal to be getting briefings about issues in the media and the impact to the business, then I think employees do expect the employer to come out and supplement the government advice with practical tips relating to their particular workplace. I think if it’s a smaller organisation which doesn’t have a sophisticated communication structure, then they wouldn’t expect to have to do that.

Roger Newport: I also think it’s important from an employee perception point of view to show the employer is aware and cares about it. I think it would be very odd for a large organisation to say absolutely nothing about swine flu.

So from a psychology point of view as well, what are the most effective methods of actually getting through?

Mandy Rutter: The reality is that we all take in information in lots of different ways, according to personality and who we are. As everyone has said here, in terms of the workplace, the most effective systems for communications are the ones that we have already: so things like individual one-to-one management sessions, team meetings, group meeting, Internet communication. So in essence, use the resources, and procedures that people are already familiar with to put the message across.

Mark Roylance: People also want trusted sources of information and the Internet is a boon for people.

Nigel Brown: Brief the teams well and provide information and then people being able to ring them and get solid advice.

Nigel, what message does BA communicate to cabin crew, dealing with the public in close proximity?

Nigel Dowdall: It’s challenging, particularly when those people fly internationally and see different practices. Most of our staff are customer facing, not just the cabin crew, it’s the check-in and gate staff, anyone who’s interacting with customers. They see people getting on aircraft wearing masks. They go to Hong Kong and the Far East and it’s common practice for people to wear masks if they have some form of respiratory infection. We have standard procedures for how they deal with somebody who has a suspected contagious disease and it is the same procedures that they would utilise for dealing with somebody with suspected flu.

But pandemic is truly an international problem, do you think the current setup is effective and cohesive?

Nigel Dowdall: I think when we compare the situation we had with SARS and the situation we had with the pandemic, it is better. This is never going to be perfect, sure. You’re never going to get experts in infectious diseases across the world to agree completely. You will get different viewpoints and you will get some different reactions. It is as good as it could be. I think we are seeing a much more effective global coordination.

Mark Roylance: Professor John Oxford, virologist, was saying that there is a potential weak link. You’ve got virologists working in human diseases and you’ve got virologists working on animal diseases, but there’s nobody actually looking at the crossover between the two and that’s potentially where swine flu fell through the cracks. People have been watching bird flu for some time but who’s watching all of the other variants that are out there?

Mark, what is the situation with regard to the pharmaceutical approach, with pharmaceutical and non-pharmaceutical interventions?

Mark Roylance: We take a layered approach, which follows normal business continuity processes. So you start with social isolation, good hand washing, hygiene etc, and then you’re moving through all of those processes and you find yourself at pharmaceutical and nonpharmaceutical interventions. You can go down an anti-viral route. We will have the vaccine at some point. We could look at face masks and respirators. But you’ve got to work out what works for your organisation and how you’re best placed.

What is the situation with stockpiling in terms of preparation?

Mark Roylance: Again, you’ve got to make a call for your own organisation. Some organisations don’t have their own occupational health department, for example, so rolling out an anti-viral programme becomes either very difficult or very expensive. So you’ve got to work with what you’ve got.

Michael, do you think the technology, i.e. the Internet etc. Is being utilised to its optimum level in terms of cohesive and practical usage, for example, getting the right information to people and giving employees flexibility. Should the workplace be closed down, due to pandemic?

Martin Calvert: Adoption of new technologies in society, tends to respond to unusual external events. What we’re seeing now is a response, not only to some of the events such as the pandemic we’re speaking about today, but also other HR and business requirements, such as the need to offer flexible working in response to an improved work life balance, better employee retention, cost savings etc. We’re now starting to see the adoption of things such as much wider usage of video conferencing, which is actually reducing the need for some, I would say, non-essential travel.

Nigel Brown: I think that the recession has been a real driver towards the use of communications technology rather than travel. And in a way it’s been going in the same direction, if you like, in parallel to the swine flu issue. But I think it is that recessionary pressure that’s driven that more than swine flu. It will be very interesting to see what happens as the economy emerges from recession as to whether that driver to avoid travel to meetings will continue.

Mandy Rutter: One of the things about a crisis situation or a situation that’s different to normal, is that people like to talk about it. Technology may well enable us to be more efficient, whether it helps us in terms of our psychological contact with our organisation and hence helping us feel good about being at work is another issue.

Looking at the longterm implications of this remote working trend, isn’t there an issue that if people are increasingly remote, that their immune system will weaken?

Kate Bellamy: Your immunity would be weaker because you’re never actually exposed to a wide range of infectious agents. One of the reasons why lots of young children become ill is because the environment is so clean all the time that they’re not actually exposed to bacteria and viruses at a young age and so their immunity does not build up.

So to put it into context, a virus which emanates from Asia, for example, that has been cultivating over a long period of time, if it was brought into a western civilisation, it could be devastating?

Mark Roylance: That would be an epidemic. Whereas if it comes from another source, ie an animal, then nobody in the world has any immunity. In humans it would be a brand new disease and therefore it can cause a pandemic as opposed to an epidemic.

Increasingly it seems that pandemic is inevitable, so planning has to be key.

Mel Flogdell: I think it is all about your business, your employees and the nature of your business and what you can do and it is about being pragmatic and sensible and demonstrating your duty of care to employees.

Christine Moore: On the technology side it’s important organisations look ahead and assess their capacity to cope, with a vastly increased number of people who might be working from home and to test their bandwidth to make sure it’s robust. And then I think on the human level, it’s important that managers think about how they’re going to interact with their teams if they’re going to be spread around, working from home, so that they don’t become isolated and that people are getting that social interaction in this rather difficult situation.

Mandy Rutter: It would also be important to remind people how important it is for the country that they work on an oil rig or a power station. Do we ever tell people how critical they are and the impact to our business when they are off sick?

So again, that’s going back to the individual taking responsibility for their individual situation

Nigel Brown: One aspect of absence that we’ve not really talked about yet is family responsibilities, because obviously, through this crisis, schools have been closed and people have had to take time off to look after family. But within this crisis it’s been at a fairly low level. In a more serious pandemic, one would expect that kind of absence would be significantly higher. And what would we do and how would we react as employers in those circumstances? Obviously there is some egislative basis for time off in lieu, time off in emergencies for parents etc, but as an organisation, how would we cope with that if all the schools in the country were closed, as happened in Mexico?

Ann Healey: Our plans at Centrica look at ten, 20, 30, 50 percent loss of workforce. Recognising that the workforce won’t just be impacted by those who are absent with swine flu but those with families, children of school age and with caring responsibilities. Concerns have been raised regarding pregnant women, and you don’t necessarily know if somebody’s got a partner that’s immuno-compromised so we have been encouraging people to talk to their manager if they have specific concerns.

Mark Roylance: Again the Department of Health has taken a layered approach and if organisations can take a layered approach; whether that be psychological, communication, support, hand washing, social distancing all the way up to vaccines, anti-virals and everything between, the more layers you have the better protected as an organisation you’ll be. And therefore, you can pick and choose as you see fit for whatever works for your organisation.

Nigel Dowdall: I think it should also be part of your business continuity plan. Then its about getting the data together to say, okay, what is our absence across the business and then what operation are we capable of delivering? And then its about matching demand with capability.

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